Evaluation of different health education interventions among preschoolers: a randomized controlled pilot trial

Effectiveness of various methods of educating children and adolescents for the maintenance of oral health: A systematic review of randomized controlled trials

BACKGROUND

School-based oral health education has emerged as one of the most effective methods to instill a positive attitude toward oral health in children.

AIM

This systematic review (SR) aimed to assess the effectiveness of different methods of oral health education in children and adolescents.

DESIGN

Systematic search was conducted in PubMed, Cochrane, Web of Science, LILACS, Scopus, and EMBASE on January 29, 2023. Review included only randomized controlled trials (RCTs), and their risk of bias (ROB) was assessed by Cochrane RoB-2. Data were extracted and analyzed by expert group. The GRADE approach was used to assess the quality of evidence for each outcome. Every step was conducted in duplicate, and disagreements were resolved by consulting the third reviewer.

RESULTS

The SR included 10 RCTs with majority showing a high ROB. They included 12 methods with the commonest being the use of leaflets/flash cards. Most interventions were effective in improving oral hygiene, gingival health, and knowledge except conventional teaching methods, lecture by using PowerPoint by dentists, and e-learning interventions. The grade of evidence in the majority of outcomes was found to be low or very low.

CONCLUSION

Interventions using the interactive methods such as games, motivational-experiential learning, and audiovisual methods were found to be more effective than controls and other interventions. Variabilities in study methods and outcome variables must be addressed in the future.

Improvement of parents' oral health knowledge by a school-based oral health promotion for parents of preschool children: a prospective observational study

BACKGROUND

Parents of preschool children have inadequate oral health knowledge in Hong Kong. Parents play a critical role in preschool children's dietary patterns and oral health behaviors. A school-based oral health promotion (OHP) for parents of preschoolers was developed and investigated.

OBJECTIVES

The objective of this study was to evaluate effects of the school-based OHP for parents of preschool children on parents' oral health knowledge and preschool children's early childhood caries (ECC).

MATERIALS AND METHODS

This was a quasi-experimental study. Parents of preschool children were divided into the intervention group (IG) and the control group (CG) according to their own selection. Parents in the IG participated in a structured school-based OHP workshop, while those in the CG did not attend the OHP workshop. Parents in both groups were invited to complete a questionnaire assessing their oral health knowledge before (T0), one month after (T1), and twelve months after (T2) the OHP workshop. Preschool children's caries was examined via dmft score at T0 and T2.

RESULTS

Parents' oral health knowledge was negatively correlated with preschool children's dmft scores (R = -0.200, P < 0.001). Oral health knowledge was significantly improved in IG (P < 0.001) but not in CG (P = 0.392) at T1. Both groups experienced a significant improvement in oral health knowledge from T0 to T2 (P < 0.001). Parents' oral health knowledge in the IG was significantly higher compared to the CG at T1 (P < 0.001), but difference in the scores at T2 between the two groups showed no significant difference (P = 0.727). No significant difference was found in changes in children's dmft score from T0 to T2 between the IG and CG (p = 0.545).

CONCLUSION

Preschool children's high ECC is associated with the limited oral health knowledge of their parents. The school-based OHP workshop for parents increased parents' oral health knowledge within one month. This positive effect was maintained for twelve months and can be extended to a larger scale in the school setting.

Effectiveness of online caries management platform in children's caries prevention: A randomized controlled trial

Purpose

To construct an online caries management platform and evaluate its efficacy in children's caries prevention based on caries risk.

Methods

The study participants were second-grade pupils. The caries risk assessment tool (CAT) was used to grade caries risk for all participants, who were randomly divided into the experimental (114 pupils) and control (111 pupils) groups. The experimental group used the Internet for caries management, while the control group was managed by traditional lecturing in classroom. The caries status of each surface of the first permanent molars was recorded. The basic information and oral health knowledge, attitude, and behaviors of participants were collected by questionnaire. One year later, outcome data were collected. Pearson's chi-squared test was used to analyze the caries risk assessment items and oral health behaviors. The Mann-Whitney U-test was used to analyze the decayed-missing-filled surfaces (DMFS) index, plaque index, and scores of oral health knowledge and attitude. P < 0.05 was considered statistically significant. This study was available on the website of Chinese Clinical Trials Register (No: MR-44-22-012947).

Results

After 1 year, the oral health knowledge score was improved by 20.58% (P < 0.001) in the experimental group and 6.02% in the control group. The plaque index was improved by 49.60% (P < 0.001) in the experimental group and 21.01% in the control group. The DMFS index increased in both groups but there were no significant differences (P = 0.608). The experimental group had a better improvement effect in caries risk assessment items than the control group, including "whether the frequency of eating sugary snacks or drinks between meals is more than 3 times/day" (P = 0.033) and the use of fluoridated toothpaste (P = 0.020). The experimental group was better than the control group in reported oral health behaviors, including frequency of eating sweets before sleep (P = 0.032), brushing time (P = 0.001), and the filled rate (proportion of FS in DMFS) of first permanent molars (P = 0.003).

Conclusions

The online caries management platform showed more advantages than traditional lecturing in improving oral health knowledge and behaviors (oral hygiene practice, sugar consumption behavior, and medical treatment behavior). This platform provides a reliable implementation path for the occurrence and continuous improvement of oral health-related behaviors.

Effectiveness of a Visual Interactive Game on Oral Hygiene Knowledge, Practices, and Clinical Parameters among Adolescents: A Randomized Controlled Trial

This study aimed to evaluate the effect of a novel interactive game-based visual performance technique (IGVP) and conventional oral health educational (OHE) talk on plaque control, gingival health, and oral hygiene knowledge and practices in 12−15-year-old schoolchildren. A single-blinded randomized controlled trial was undertaken in a private primary school in Belagavi, Karnataka, India. A total of 100 children aged 12−15 years were randomly assigned to either a conventional OHE talk (control group, n = 50) or the IGVP technique (test group, n = 50), using a computer-generated table of random numbers. A self-designed, pre-validated closed-ended questionnaire was collected from both groups, followed by clinical examination carried out using gingival and plaque index, pre- and post-intervention, at three months follow-up. There was a significant reduction in the mean gingival score and plaque score in the test group after intervention, indicating a 58.7% and 63.4% reduction, when compared to the control group, which had a 2.8% and 0.7% reduction, respectively (p < 0.001). The test group showed a significant increase in the percentage of knowledge gained (22.4%), compared to control group (7.8%). The IGVP technique proved to be more effective than a conventional OHE talk in the reduction of the plaque score, gingival score, and in the improvement of the knowledge of oral hygiene maintenance and its application.

Effectiveness of Oral Health Educational Methods among School Children Aged 5–16 Years in Improving their Oral Health Status: A Meta-analysis

Background

Oral health is an essential component of health throughout life. Two major oral diseases, dental caries and gingival conditions are prevalent in young population. School-based oral health education (OHE) programs with recognized technology and traditional lecturing could be strategic in promotion of oral health behavior in developed and developing countries.

Aim

The aim of the study is to summarize existing evidence in order to evaluate the effectiveness of OHE programs in school children aged 5–16 years in improving their oral health status.

Methodology

Clinical trials with school children between 5 and 16 years were included. Eligible studies were those which had outcomes as caries, plaque and gingival indices, and oral hygiene status. Articles published from 2010 to 2019 in English language from PubMed, Directory of Open Access Journal (DOAJ), and Google Scholar were searched. Forty-one articles were identified and relevance was determined by examining title and full article. Nine articles were included for qualitative synthesis and seven were eligible for meta-analysis. The risk of bias was assessed by Cochrane Handbook. A meta-analysis was done using Review Manager 5.3 software.

Results

After the meta-analysis results for cumulative mean difference was found as 0.05 (–0.17, 0.27), –0.37 (–0.74, 0.00), –0.20 (–0.33, –0.07), and –0.17 (–0.73, 0.38) for plaque status, Oral Hygiene Index-Simplified (OHI-S), debris status, and dental caries, respectively showing a significant difference favoring the experimental group than traditional group.

Conclusion

Interventions given by various aids like lectures, albums, models, flipcharts, leaflets, E-programs, games, drawings, and presentations proved effective in improving oral hygiene status and dental caries, but no reduction in plaque levels and gingival inflammation as compared to oral health talk/counseling by dentists.

How to cite this article

Gurav KM, Shetty V, Vinay V, et al. Effectiveness of Oral Health Educational Methods among School Children Aged 5–16 Years in Improving their Oral Health Status: A Meta-analysis. Int J Clin Pediatr Dent 2022;15(3):338-349.

Effect of educational strategy combined with ART on oral health-related quality of life: a controlled clinical trial

This study aimed to assess whether complementing atraumatic restorative treatment (ART) with oral health educational strategies (OHES) improves the perception of oral health-related quality of life (OHRQoL) and clinical oral outcomes. A controlled clinical trial included 93 six- to eight-year-old students from five public schools of Piracicaba, Saltinho, and Charqueada municipalities (State of São Paulo, Brazil) divided into 3 groups (31 children each) which received: OHES (caries-free), ART (dental caries), and ART plus OHES (dental caries). OHRQoL (CPQ8-10-ISF:16), dental caries, biofilm control, and gingivitis were assessed before and 1 month after interventions by one calibrated examiner. OHES consisted of an educational interactive activity performed once a week for four weeks. Data were analyzed using mixed model ANOVA, Chi-square, and Sign tests. After 1 month of follow-up, improvement in gingivitis status, OHRQoL total score, and Functional Limitations, Emotional Well-Being and Social Well-Being domains scores were found in all groups (p < 0.05). The improvement in biofilm control was observed only in the OHES group (p < 0.001; power = 0.98), while a decrease in Oral Symptoms scores was observed only in ART+OHES group (p <0.001; power = 0.99) and a significant change in the perception of oral health was observed in the two groups that received ART (p < 0.05). In conclusion, improvement in overall OHRQoL and oral status was observed in all children, although the effect of including health educational strategies in the treatment plan was determinant for the perception of an improved oral health after restorative treatment.

Effectiveness of the school-based oral health promotion programmes from preschool to high school: A systematic review

BACKGROUND

Schools offer an opportunity for oral health promotion in children and adolescents. The purpose of this study was to conduct a systematic review of the influence of school-based oral health promotion programmes on oral health knowledge (OHK), behaviours (OHB), attitude (OHA), status (OHS), and quality of life (OHRQoL) of children and adolescents.

METHODS

A systematic search on the PubMed and Embase databases was conducted to identify eligible studies. The last search was done on April 24th, 2020. The quality of the included studies was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal tools.

RESULTS

Of the 997 articles identified, 31 articles were included in this review. Seven studies targeted students in preschools, seventeen in elementary schools, and seven in high schools. Most of these studies revealed positive outcomes. Some studies showed that the school-based oral health promotion programmes showed better OHK, OHB, OHS, and OHRQoL.

CONCLUSION

Positive results were obtained through oral health promotion programmes in schools, especially those involving children, teachers, and parents.

Using street plays as a populist way to spread eye health awareness: An experience

Street plays are a popular traditional medium of communication and entertainment in India. The objective of this paper is to communicate our experience about using street plays to raise awareness about children's eye health in a South Indian setting. Based on our experience of the prevailing misconceptions about children's eye health in our community, we selected some topics and prepared a blueprint of the scripts. We hired professional troupes who further refined these scripts into traditional street play scenarios by adding traditional songs, humor, and dialogues in the local dialect, leaving adequate room for improvisation during actual play. After a few rehearsals, we finalized the actual plays. Then, these were enacted in different parts of the city on different occasions, over a span of 3 years. In this descriptive paper, we share our experience of this exercise so that others may try and replicate this initiative in their areas. We found that the street plays were well attended by the people indicating the popularity of this medium in local communities. At the end of the street plays, a sample audience was interviewed about what they understood from the sessions, and most of them could reproduce the key messages. We found that instead of training our own staff, hiring a professional troupe was a more practical choice. Overall, it was a fruitful exercise in terms of the number of people that our plays reached out to effectively. Thus street play is an effective and popular means of disseminating eye health messages in our communities.

Teaching Preschool Children Correct Toothbrushing Habits Through Playful Learning Interventions: A Randomized Controlled Trial

PURPOSE

This study aimed to investigate the effect of playful learning interventions (with toys, visual and auditory sources) on appropriate toothbrushing behaviors and the amount of accumulated plaque in preschool children.

DESIGN AND METHODS

The study was carried out as a parallel-group, randomized and controlled study during the period October-December 2018, with 100 preschool children. The preschool students were randomly assigned to an intervention and a control group. The children in the intervention group were given instructions on how to brush their teeth while the children in the control group were not given any instruction outside of what they had learned in preschool. The playful learning interventions that were carried out consisted of three rounds of meetings designed to educate the children about adopting appropriate toothbrushing behaviors.

RESULTS

The study groups were well matched at baseline (p = .537) and the intervention group showed statistically significant improvements in toothbrushing (p = .001) and plaque control (p = .001) following the intervention in comparison to the controls. Additionally, while the amount of plaque decreased in the children in the intervention group (p = .001), plaque increased in the control group after the intervention (p = .001).

CONCLUSIONS

This study showed that after the playful learning interventions carried out with the preschool children, appropriate toothbrushing behaviors were acquired and there was a decrease in the amount of plaque.

APPLICATION TO PRACTICE

Nurses who work with preschool children could use toys and songs as effective and entertaining nursing interventions for developing correct toothbrushing behaviors.

Impact of different modes of school dental health education on oral health-related knowledge, attitude and practice behaviour: an interventional study

PURPOSE

The study was planned to evaluate the effectiveness of three modes of school dental health education (SDHE) on the oral health-related knowledge, attitude and practice (KAP) behaviour of school children.

METHODS

An interventional study was carried out among 8-9 year old school children from January 2016 to January 2018. Three hundred and sixty children from three schools in Tiruchengode, Tamil Nadu, India participated in this study. Each school was randomly allotted with a mode (drama, modified snake and ladder game, flashcard) of SDHE, which was delivered for 20 min, every 6 months for 2 years. A validated questionnaire with 18 questions was used to record oral health-related KAP behaviour at baseline and after 2 years.

RESULTS

At the end of 2 years, there was an increase in the percentage of correct response for all the nine knowledge questions, in all the three modes. The mean difference in the cumulative knowledge score between baseline and 2 years was 1.39 ± 2.05 for drama mode, 1.8 ± 1.51 for game mode and 1.7 ± 1.5 for flashcard mode of SDHE. There was a significant difference in three knowledge questions and one attitude practice behaviour question between the three groups at the end of 2 years.

CONCLUSIONS

All the three modes were effective in improving the oral health-related KAP behaviour of school children. Game mode made a better impact on the knowledge scores of these children, and it was observed to be more child-friendly and entertaining.

Promoting oral care in the preschool child: effects of a playful learning intervention

Objective

To compare the number of appropriate behaviors for tooth brushing before and after a playful learning intervention with preschool children.

Method

A quasi-experimental, quantitative, before and after study design was conducted in an early childhood educational institution, with children between three and five years of age. The intervention consisted of three meetings with educational activities about tooth brushing, whose outcome was evaluated by means of observation of ten behaviors suitable for tooth brushing.

Results

Forty-four children participated in the study. The mean of adequate behaviors was 4.4 before the intervention, and 8.5 after the intervention. A significant increase in the adoption of appropriate behaviors for tooth brushing (p <0.01) was identified.

Conclusion

Nurses can enhance oral health promotion actions with preschoolers in preschool institution using playful learning interventions.

Effect of Conventional and Game-based Teaching on Oral Health Status of Children: A Randomized Controlled Trial

Aim: To compare the effectiveness of conventional and game-based teaching on the level of knowledge and practice regarding oral hygiene among 7 to 10-year-old school children.

Materials and methods: A total of 60 children aged 8 to 10 years were randomly divided into two groups: groups A and B. The intervention was started after the pretest evaluation of their knowledge regarding oral health and estimation of Debris Index-simplified (DI-S). Children in group A were given oral health education through flash cards once daily for 7 days. Children in group B were educated through the play-way method, i.e. connect the dots game combined with flash cards. The evaluations, regarding oral hygiene and DI-S were recorded on the 8th day after intervention. A follow-up score was also recorded after 1 and 3 months. Statistical analysis was done using paired t-test and Chi-square test.

Results: There was significant increase in oral hygiene scores and decrease in debris scores compared to baseline in both groups at 1 week and 1 month. At 3 months interval, both groups showed a decrease in oral hygiene scores from baseline with group B showing highly significant reduction. The mean increase in knowledge score was also significantly better in group B (p < 0.05).

Conclusion: The connect the dots game that includes oral health guidelines including good dental hygiene and dietary habits can thus be an effective intervention aid for teaching the basic oral health concepts among school going children.

How to cite this article: Kumar Y, Asokan S, John B, Gopalan T. Effect of Conventional and Game-based Teaching on Oral Health Status of Children: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2015;8(2):123-126.